19D2103559 CLIA NUMBER - WALMART PHARMACY 10-5081

Laboratory Demographics

  • CLIA Code: 19D2103559
  • Facility Name: WALMART PHARMACY 10-5081
  • Facility Address: 2500 ARCHBISHOP HANNAN BLVD
    MERAUX, LA
    ZIP 70075
  • Facility Phone: 479 273-6418
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINH M. HAN
  • NPI Number: 1104299650
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2103559
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5081
Street 2500 ARCHBISHOP HANNAN BLVD
City MERAUX
State LA
ZIP 70075
Phone 479 273-6418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2025
Certificate Expiration Date 10/14/2027
Facility Type Pharmacy
Lab Director LINH M. HAN

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This page was last updated on: 9/29/2025